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Boucher NA. Family caregiver lived experience matters in home- and community-based services. J Am Geriatr Soc 2024. [PMID: 39319423 DOI: 10.1111/jgs.19120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Accepted: 07/07/2024] [Indexed: 09/26/2024]
Abstract
AbstractThis editorial comments on the article by Trivedi et al.
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Affiliation(s)
- Nathan A Boucher
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, North Carolina, USA
- Division of Geriatrics, Department of Medicine, Duke University, Durham, North Carolina, USA
- Sanford School of Public Policy, Duke University, Durham, North Carolina, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Duke-Margolis Center for Health Policy, Duke University, Durham, North Carolina, USA
- Center for the Study of Aging, Duke University School of Medicine, Durham, North Carolina, USA
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Association of Lifetime TBI and Military Employment with Late-Life ADL Functioning: A Population-Based Prospective Cohort Study. Arch Phys Med Rehabil 2021; 102:2316-2324.e1. [PMID: 34283993 DOI: 10.1016/j.apmr.2021.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/11/2021] [Accepted: 06/29/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine associations of traumatic brain injury (TBI) and military employment with activities of daily living (ADL) in late life. SETTING Community-based integrated healthcare delivery system. PARTICIPANTS Male (n=2066) and female (n=2887), aged 65+ and dementia-free. DESIGN Population-based prospective cohort study with biennial follow-up and censoring at time of dementia diagnosis. MAIN OUTCOME MEASURES ADL difficulties at baseline and accumulation during follow-up. RESULTS TBI with loss of consciousness (LOC) before age 40 was associated with slightly higher ADL difficulty at baseline for females (RR=1.44, 95% CI: 1.08-1.93, p=0.01). For males, TBI with LOC at any age was associated with greater ADL difficulty at baseline (age <40: RR=1.58, 95% CI: 1.20 - 2.08, p = 0.001; age 40+: RR=2.14, 95% CI: 1.24 - 3.68, p = 0.006). TBI with LOC was not associated with the rate of accumulation of ADL difficulties over time in males or females. There was no evidence of an association between military employment and either outcome, nor of an interaction between military employment and TBI with LOC. Findings were consistent across a variety of sensitivity analyses. CONCLUSION Further investigation into factors underlying greater late-life functional impairment among TBI survivors is warranted.
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Lucchese SP, Bishop S, Guruge S, Zanchetta MS, Pirner D. Finding the Silver Lining: Aging Well Amongst Older Brazilian Women in the Post-Migration Context. Can J Nurs Res 2021; 54:156-167. [PMID: 33752458 DOI: 10.1177/08445621211004332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
STUDY BACKGROUND The aging population in Canada has been increasing steadily over the past 40 years, however, there is limited information about the meaning of aging well amongst older Brazilian women in Canada. METHODS A Heideggerian interpretive phenomenology study was conducted to understand the meaning of aging well amongst older Brazilian women in the post-migration context living in the Greater Toronto Area (GTA) in Ontario, Canada. RESULTS Eight older Brazilian women residing in the GTA were recruited through purposive and snowball sampling and participated in individual face-to-face interviews. Through data analysis and the incorporation of Heidegger's four existentials of human existence, the themes that emerged were (a) Embracing being part of a mosaic, (b) Aging with grace, (c) Chasing your dreams and (d) Being a bridge and not a fence. The overarching theme was: Finding the silver lining: Aging well. CONCLUSION This study informs nursing practice, research and policy development to advance the health of older immigrant adults in Canada.
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Affiliation(s)
| | - Susan Bishop
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
| | - Sepali Guruge
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
| | | | - Diane Pirner
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
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Fogle BM, Tsai J, Mota N, Harpaz-Rotem I, Krystal JH, Southwick SM, Pietrzak RH. The National Health and Resilience in Veterans Study: A Narrative Review and Future Directions. Front Psychiatry 2020; 11:538218. [PMID: 33362593 PMCID: PMC7755975 DOI: 10.3389/fpsyt.2020.538218] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 10/27/2020] [Indexed: 12/26/2022] Open
Abstract
United States (U.S.) veterans are substantially older than their non-veteran counterparts. However, nationally representative, population-based data on the unique health needs of this population are lacking. Such data are critical to informing the design of large-scale outreach initiatives, and to ensure the effectiveness of service care delivery both within and outside of the Veterans Affairs healthcare system. The National Health and Resilience in Veterans Study (NHRVS) is a contemporary, nationally representative, prospective study of two independent cohorts (n = 3,157 and n = 1,484) of U.S. veterans, which is examining longitudinal changes, and key risk and protective factors for several health outcomes. In this narrative review, we summarize the main findings of all NHRVS studies (n = 82) published as of June 2020, and discuss the clinical implications, limitations, and future directions of this study. Review of these articles was organized into six major topic areas: post-traumatic stress disorder, suicidality, aging, resilience and post-traumatic growth, special topics relevant to veterans, and genetics and epigenetics. Collectively, results of these studies suggest that while a significant minority of veterans screen positive for mental disorders, the majority are psychologically resilient. They further suggest that prevention and treatment efforts designed to promote protective psychosocial characteristics (i.e., resilience, gratitude, purpose in life), and social connectedness (i.e., secure attachment, community integration, social engagement) help mitigate risk for mental disorders, and promote psychological resilience and post-traumatic growth in this population.
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Affiliation(s)
- Brienna M. Fogle
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, United States
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Jack Tsai
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, United States
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Natalie Mota
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, United States
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Ilan Harpaz-Rotem
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, United States
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - John H. Krystal
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, United States
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Steven M. Southwick
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, United States
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Robert H. Pietrzak
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, United States
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, United States
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Hou Y, Wu Q, Zhang D, Jin X, Wu W, Wang X. The differences in self-perceptions of aging, health-related quality of life and their association between urban and rural Chinese older hypertensive patients. Health Qual Life Outcomes 2020; 18:154. [PMID: 32456638 PMCID: PMC7249344 DOI: 10.1186/s12955-020-01411-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 05/19/2020] [Indexed: 12/21/2022] Open
Abstract
Background Most hypertensive clients are elderly, whose health-related quality of life (HRQL) may be associated with self-perceptions of aging (older individuals’ beliefs about their own aging). Meanwhile, culture and health disparities between rural and urban populations are substantial. Whether there are differences in self-perceptions of aging, HRQL, and their association among elderly hypertensive clients in urban and rural areas remains unknown. The objective of this study was to investigate and compare self-perceptions of aging and HRQL and their association among urban and rural older Chinese hypertensive clients. Methods A cross-sectional investigation was conducted in 15 urban community clinics and 22 village clinics from Suzhou, China. Older hypertensive adults were invited to complete a self-administered questionnaire addressing socio-demographic and clinical information, HRQL and self-perceptions of aging. Results There were 492 urban participants and 537 rural participants included in the analyses. The physical (40.0 ± 12.1 vs. 30.9 ± 8.9, P < 0.001) and mental (51.5 ± 8.3 vs. 46.0 ± 7.8, P < 0.001) HRQL scores of urban participants were all higher than those of rural ones. Urban participants’ scores on dimensions of “timeline cyclical”, “consequences negative”, and “control negative” of self-perceptions of aging questionnaire (APQ) were lower than those of rural participants (P < 0.001, respectively), while the scores on dimensions of “consequences positive” and “control positive” were higher (P < 0.001, respectively). Adjusted multivariate linear regression showed that participants who had worse self-perceptions of aging had poorer HRQL. Some APQ dimensions associated with urban or rural hypertensive elders’ HRQL were different. Conclusions Older hypertensive clients in rural areas have poorer self-perceptions of aging and HRQL than those in urban areas. Health care professionals should pay more attention to HRQL and self-perceptions of aging of older hypertensive clients in rural areas.
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Affiliation(s)
- Yunying Hou
- Department of Cardiology, the First Affiliated Hospital of Soochow University, Suzhou, 215006, China.,School of Nursing, Soochow University, Suzhou, 215006, China
| | - Qing Wu
- Department of Cardiology, the First Affiliated Hospital of Soochow University, Suzhou, 215006, China.,School of Nursing, Soochow University, Suzhou, 215006, China
| | - Dandan Zhang
- Department of Cardiology, the First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Xiaohong Jin
- Quality Improvement Office, Changshu No.1 People's Hospital, Changshu, 215500, China
| | - Wenya Wu
- Department of Cardiology, Changshu No.1 People's Hospital, Changshu, 215500, China
| | - Xiaohua Wang
- Department of Cardiology, the First Affiliated Hospital of Soochow University, Suzhou, 215006, China. .,School of Nursing, Soochow University, Suzhou, 215006, China.
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Bowen ME, Gaynor B, Phillips LJ, Orsega-Smith E, Lavery A, Mitchell AB, Basehore HK. Factors Associated With Health Service Use Among Older Adults in a Mobile Veterans Program. J Gerontol Nurs 2020; 46:15-22. [PMID: 32324891 DOI: 10.3928/00989134-20200313-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 12/03/2019] [Indexed: 11/20/2022]
Abstract
The current retrospective, longitudinal study applied Andersen's Behavioral Model of Health Services Use to examine how demographic characteristics (age), available resources (e.g., a caregiver, the Mobile Veterans Program [MVP]) and health needs (e.g., cognitive and physical functioning, depressive symptoms) affect hospitalization and institutionalization outcomes among older adults using the MVP. Fifty-four Veterans (age 55 to 95) participating in the MVP for up to 2 years were examined using hierarchical linear modeling (HLM) and growth curve model. In the final HLM model, each 1-point increase in depressive symptoms was associated with 76% (p ≤ 0.05) greater risk of institutionalization and 40% (p ≤ 0.01) greater risk of hospitalization. Each 1-point increase in cognitive functioning was associated with 24% (p ≤ 0.05) lower risk of institutionalization. The relationship between caregiver burden and hospitalization was attenuated by frequency of MVP visits. Services focused on reducing depressive symptoms may influence health service use and reduce caregiver burden in this population. [Journal of Gerontological Nursing, 46(5), 15-22.].
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Cuevas H, Zuñiga J. Latinx with Type 2 Diabetes: Perceptions of Cognitive Health. J Immigr Minor Health 2020; 23:337-343. [DOI: 10.1007/s10903-020-00995-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Abstract
Successful aging is a prominent theory that describes the aging process and the expected activities and behaviors older adults should engage in or exhibit to age successfully. Although this theory is used to gauge the extent to which older adults are aging successfully, older adults' experiences and perspectives of what successful aging means to them are missing from the theory. A five-step scoping review framework was used to explore and synthesize the existing research that investigated older adults' perspectives on successful aging. Twelve main themes were found and ranged from the importance of social relationships and interactions to having a good death. Findings indicated older adults do not define successful aging as strictly as is found in the literature. Old age and the aging process from the views of older adults provide future directions for theory development and research.
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Affiliation(s)
- Barbra Teater
- Department of Social Work, College of Staten Island, City University of New York, Staten Island, NY, USA
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Yeung P, Allen J, Godfrey HK, Alpass F, Stephens C. Risk and protective factors for wellbeing in older veterans in New Zealand. Aging Ment Health 2019; 23:992-999. [PMID: 29781708 DOI: 10.1080/13607863.2018.1471584] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Objectives: To compare indicators relating to aging and health among veterans and non-veterans, and identify factors associated with subjective wellbeing (SWB) of older New Zealand veterans. Methods: Self-reported data were obtained from participants in a longitudinal cohort study of New Zealand older adults. Responses from 352 veterans and 1500 non-veterans (age range of 55-86 and gender matched) were selected as a comparison group on indicators related to health and aging. The association of these indicators with veterans' SWB were assessed using hierarchical regression. Results: Apart from being older, smoking more, and having more chronic conditions, veterans did not differ from non-veterans on indicators of health and wellbeing. Mental health, physical health, purpose in life, housing satisfaction, and capabilities (choice and freedom) accounted for a significant amount of variance in veterans' SWB. Conclusion: Our results suggest that older veterans do not differ greatly on indices of health and aging from their non-veteran peers. Results support previous findings that lower mental and physical health is associated with lower SWB for veterans. Building upon prior findings, the current results demonstrate that interventions focusing on enhancing a sense of purpose in life, supporting one's capability to achieve, and strengthening social and physical environment through social connectedness, may serve as protective factors for SWB in veterans.
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Affiliation(s)
- Polly Yeung
- a School of Social Work , Massey University , Palmerston North , New Zealand
| | - Joanne Allen
- b School of Psychology , Massey University , Palmerston North , New Zealand
| | - Hazel K Godfrey
- b School of Psychology , Massey University , Palmerston North , New Zealand.,c School of Psychology , Victoria University of Wellington , Wellington , New Zealand
| | - Fiona Alpass
- b School of Psychology , Massey University , Palmerston North , New Zealand
| | - Christine Stephens
- b School of Psychology , Massey University , Palmerston North , New Zealand
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